From talking to his friends, the boy knew the doctor would touch him in his genital area. "I don't want him to do that!" he complained.

But Powell, who also has a 15-year-old daughter, talked to her son about what to expect and why the exam was necessary. She also asked him if he wanted her to be with him during the exam.

She thinks parents can do a lot to defuse what experts call a natural reluctance in adolescents about having a doctor see their private parts.

"I told them (her children) it's just a routine part of the exam," says Powell, a nurse practitioner at Planned Parenthood's health clinic in Stroudsburg.

"Little boys have to have their penises and scrotums checked, and little girls have to have their labia checked. ... It's just one of those things you have to do."

To many experts, the key to preparing a child for the genital part of a physical exam that parents and doctors consider appropriate is understanding the emotions the child might feel.

Ann Friedenheim, an Allentown psychologist with a speciality in sexual abuse, says young children are rarely bothered by having their genitals looked at by a doctor. But for a preteen or teen, it's a different story.

A genital exam can tap into big issues in the child's emotional development.

Around sixth grade, most children enter puberty and experience its accompanying physical, social and emotional upheavals. That's the age of the plaintiffs in the much-publicized federal court case involving genital exams in the East Stroudsburg Area School District.

"When children go through puberty, their bodies change, and they're having more sexual feelings," she explains. "They're not yet comfortable with that part of their body or their sexuality. ... It's a strange age to have people looking at your genitals."

The increased emphasis in recent years on teaching children about sexual abuse and "good" and "bad" touch could contribute to confusion about a doctor's role, she adds.

"We try to teach them that only a mother and father should (touch a child) and only a doctor in certain ways for a medical reason," Friedenheim says.

But the second part of the message might get lost on children -- and not even be clear to adults.

In a medical setting, looking at and touching the genitals generally isn't sexual abuse because the doctor is doing both for the patient's benefit and not for his or her own gratification, nurse practitioner Powell stresses.

"It's not like having a boy or a stranger or someone else look at your genital area or touch you," she emphasizes.

Dr. Leslie Carroll, chief of pediatrics at Allentown's Cedar Crest Hospital and a specialist in adolescent medicine, says the key to preparing a child for a physical is for parents to keep things low-key.

Generally, doctors don't make a big deal about the genital part of an exam, she says. The exam is not painful and is over in a moment or two. No instruments are used.

"I would minimize the genital exam," Carroll says of her approach to young patients. "I would say, `We want make sure everything is healthy.' "

The main reason for doing a genital exam is to make sure the genitals are maturing normally, according to the American Academy of Pediatrics.

Overdeveloped or underdeveloped genitals can signal an underlying hormonal problem requiring treatment, says Dr. James Anasti, a reproductive endocrinologist at St. Luke's Hospital in Fountain Hill.

"These are rare conditions, but they do exist," he says.

For boys, a doctor visually examines the penis and scrotum and may touch to check for conditions such as a hernia, tumor or undescended testicle.

For girls, a doctor may manually spread the labia, the outer lips surrounding the entrance to the vagina, to look for signs of infection, sexual activity or sexual abuse.

If a girl is sexually active, an internal pelvic exam, which is different from a genital exam, is in order, according to the American College of Obstetricians and Gynecologists.

For girls who are not sexually active, pelvic exams should begin at age 18, the gynecologists' group recommends. It also recommends that girls begin at puberty to visit a gynecologist to be educated about sexuality and women's health issues.

Lorraine Pierotti, spokeswoman for Planned Parenthood of North East Pennsylvania, says parents can use a physical exam as an opportunity to teach their children the names and functions of their sexual body parts -- a subject that might not be covered in school.

"Pennsylvania has no state requirement for sex education," she notes. There is, however, a requirement to teach about the Human Immunodeficiency Virus (HIV) that causes AIDS and about sexually transmitted diseases.